THE ROLE OF THE NURSING HOME ADMINISTRATOR

                                                     

THE ROLE OF THE ADMINISTRATOR

OR

WHAT THE HECK IS GOING ON?

     I’ve been in the business a long time and have seen many changes and modifications.  Some good; some not so good. 

But lately, I’ve observed a disturbing trend in the expectation of the Licensed Administrator.  I’ve only worked in two States, so I don’t know what’s going on in the rest of the country.  But where I have worked, I don’t like what I’m seeing.  

     We should start with these questions: What exactly is a licensed administrator’s role within the industry?  What responsibilities do we have and what duties should we be performing?  And furthermore, what should we as the chief operations officers focus our attention on?  I believe that the answer to these questions should be very obvious.  The lead person in charge MUST be responsible for the product that their organization produces so that it can be most effectively marketed and sold.  

     In the nursing home industry, our product is the development and presentation of high quality healthcare services to our customers in a pleasant, clean, and home-like environment.  Since a nursing home is, in essence, a health care hotel, we must excel in both areas simultaneously.  So, to do this, where should we focus our time?  It seems obvious to me that an effective nursing home administrator must be an expert in understanding clinical services provided to our

residents(customers). 

He or she must be able to challenge the clinical experts among our staffs to assure that the best medical services are being provided.  Likewise, we must also understand the principals of hotel management so that the best Maintenance, Housekeeping, Dietary, and Linen Services are provided at the highest levels.  This is why our Quality Assurance programs are so vitally important to our success and survival.  

     Unfortunately, this trend that I’ve mentioned is not what I’m seeing.  The emphasis is increasingly being directed to the fiscal requirements of the organization.  Of course, nursing homes must be financially sound (like any business). This is achieved in our industry through fiscally effective census levels, successful collection systems, and prudent financial management.  That’s a given. 

But sadly, what I’m seeing in too many organizations is the relegation of duties to the Administrator that should be assigned to the Finance Department.  The Administrator MUST be allowed to focus on the resident, not on overwhelming report writing for government agencies (i.e. COVID Reporting), or overseeing purchasing processes, or spending exorbitant amounts of time on “Flash” financial report reviews.  

     I split my time between New York State and Florida and have worked in both of these industry arenas.  From experience I can say that Florida Administrators are engulfed in this unfortunate situation and I’m sorry to say that New York seems to be on its way as well.

  

     I’m certainly not saying that I don’t trust our clinical staffs, but we, as licensed administrators, must oversee and hold them accountable.  The only way to do this is to thoroughly understand what they do.  We don’t need to be doctors or nurses to do this, but we must be given the time and training to accomplish this.  This isn’t possible if we are directed to carry out fiscal or clerical tasks.

  

     As this trend grows, along with the impact of the COVID Pandemic, I’m convinced that the quality of America’s nursing homes is beginning to decline. 

This can and must be corrected.